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Hitting Bottom

Last spring, at the Pasadena Recovery Center, while staff members were doing their morning rounds, three men sat behind the closed door of a dim in-patient bedroom. Members of a video production team, they were monitoring live feeds on glowing screens in a part of the Los Angeles drug-and-alcohol unit then serving as an ad-hoc command center for “Celebrity Rehab With Dr. Drew” — a reality show on which celebrities who habitually alter their realities receive treatment for their addictions from a celebrity. On TV.

Three mounted widescreens were broken into a dozen digital monitors, each showing a face from television past: Dennis Rodman, Heidi Fleiss, Mackenzie Phillips, Tom Sizemore and other less-celebrated substance abusers filled surveillance shots from around the building, the composite grid of video screens suggesting “Hollywood Squares” as directed by David Cronenberg. In one square, Sizemore, an actor known for playing hardboiled military men in such movies as “Black Hawk Down” and “Saving Private Ryan,” lay half conscious in his bed, detoxing from heroin, crystal meth, benzodiazepines and marijuana. He’d been in that state for two days, said Mark Perez, the show’s supervising producer, which didn’t seem to augur for great TV. But moments later, when I checked back in with Sizemore, the entire screen had lighted up: Dr. Drew Pinsky had entered the frame.

Dr. Drew edged up to the pajama-clad Sizemore, bent over his bed to draw some blood and then left — only to appear the next screen over. Robocams and roving camera operators tracked the show’s star from room to room, as he ministered to nine fallen souls. Perez alerted a cameraman of Pinsky’s approach — “Mustang, coming to you, in three, two . . . one . . . ” — as he passed across another screen, then another, to enter through the door right beside me.

“What’s happening?” Pinsky said, greeting me with a sly half-smile, looking and talking just like TV’s Dr. Drew. He carried a clipboard and wore a tie, a cobalt dress shirt and pleated gray trousers, his gym-buff torso suggesting a medical-board-certified Clark Kent. Unlike the hospital scrubs Dr. Mehmet Oz wore to Oprah’s soundstage, the stethoscope around Pinsky’s neck was not a prop; it had just been used to check Tom Sizemore’s lung capacity. Pinsky’s close-cropped silver hair and crow’s feet lent him a gravitas that befitted his 20-plus years’ experience treating addiction, while his tanned skin and stylish rectangular glasses attested to his camera readiness: Dr. Drew, face of addiction medicine, surgeon general of youth culture and now — either through unsurpassed gamesmanship or cultural harmonic convergence — something even greater. Perhaps even, as the media scholar Mark Andrejevic would have it, “TV giving itself a moral center.”

With a glance to the screens, the moral center turned to confer with Perez and John Irwin, one of the show’s executive producers. “Did you see that?” Pinsky asked Irwin. “Sizemore? He’s sick.” As they moved on to other patients, Pinsky, Irwin and Perez conferred, like three members of a rehab team. “How was Kari Ann?” asked Irwin, referring to the meth-addicted former Miss United States Teen Kari Ann Peniche. “Kari Ann was good,” Pinsky said. “I did Dennis — he committed to not drinking, but he’s ambivalent about 12 Step.”

Pinsky then reported on his unfilmed, one-on-one session with Lisa D’Amato, an “America’s Next Top Model” contestant and alcoholic, who had relayed a harrowing memory that he planned to bring up in a group therapy session. Not a half-hour later, as Perez and I watched on three screens covering the therapy room, Pinsky prompted D’Amato to share this story with six patients, two camera operators and, potentially, 1.2 million viewers.

“I don’t want to cry again,” D’Amato protested. “Just tell them the story,” Pinsky gently urged. Then, as Perez gave directions from the control room, D’Amato puffed out a deep breath and began. “Um . . . I went on a European trip?” she said and then stopped, eyes pooling. Pinsky watched patiently, a clipboard on his lap. As D’Amato began to haltingly recount her traumatic memory, Perez positioned his crew to zero in.

“Um . . . my mom was upset with me,” D’Amato said, “I was pushing her buttons and she was pushing mine.” Perez called out to Sarah, a camera operator, to move in. D’Amato’s voice became tiny, then started trembling and, as she finished her brief tale of a life-scarring confrontation, she broke into sobs. A screen held a close-up of her doe-eyed, tear-streaked face. “Thank you so much, Sarah,” Perez said in a reverent sotto voce. “Thank you.”

Dr. Drew is a TV doctor seemingly engineered for this moment. Unlike talk-show therapists whose go-to prescription is “get real,” he commands an unusual blend of medical credentials and pop-culture savvy — he is fluent in textese, neuroscience, nitrous hits and psychodynamics, which he combines with a cool, eloquent charisma honed over 25 years in the media. In 1983, when Pinsky was a student at the University of Southern California medical school, KROQ radio introduced “Loveline,” a new late-night call-in segment that was just catching on with listeners, who tuned in to the program’s D.J.’s as they fielded requests for sex and relationship advice. Pinsky hadn’t been following “Loveline,” but a friend at KROQ approached him and asked him to appear in a new segment being developed called “Ask a Surgeon.” Though not yet licensed to practice medicine, Pinsky — who by day was watching the AIDS epidemic unfold at his hospital and who believed that the reigning sex expert, Dr. Ruth, with her focus on ridding Americans of their repressions, was at odds with the younger, quite-unrepressed generation — eventually, though somewhat reluctantly, agreed.

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Credit
Jeff Minton for The New York Times

He soon became a regular on and then a host of “Loveline,” which went national in 1995. In 1996, with the comic Adam Carolla installed as barstool wiseguy to Pinsky’s expert, the show moved to MTV, marking the small-screen debut of Dr. Drew: a young crush-worthy doctor in a tie but no jacket, with an easygoing, nonjudgmental manner. The show added celebrities and a homey, denlike set, but the main attraction remained Pinsky, who, even as he shared a sofa with gangsta rappers and teen-flick hotties, gave calm, informed answers to questions about anal sex or Nyquil abuse that were, in their very earnestness, sensational.

In a sense, Pinsky has played some version of this high-profile mensch his whole life. At Pasadena’s Polytechnic High School, he was a top student and captain of the football team, and played Tevye in “Fiddler on the Roof.” He went on to Amherst College and then returned to Los Angeles to attend medical school. After months of balancing med school with his radio-show job, he began a residency in internal medicine at Huntington Memorial Hospital, while moonlighting at Aurora Las Encinas Hospital in Pasadena, where he provided basic medical care to psychiatric patients, many of whom were also addicts. It was there that Pinsky had a burning-bush moment: he was struck by the disease’s narrative arc.

“I watched these people — these young people — go from dying to better than they ever knew they could be,” he said. “And I was like, ‘Whoa.’ In medicine you go from dying to chronically ill. You don’t go from dying to better than you ever knew you could be. That just doesn’t happen.”

Over the next several years, Pinsky was certified in addiction medicine, an emerging specialty; underwent additional training in related fields; and became the medical director of Las Encinas’s addiction program. “For me, addiction exposes all of the brain mechanism under the influence of a profoundly distorted primary motivation,” Pinsky said. “It’s such a window into how we function as human beings. And the patient doesn’t know that’s happening! Doesn’t believe that’s happening! That’s the fascinating part.”

Pinsky maintained the media presence he had established, hosting “Loveline” five nights a week on KROQ, doing health shows for MTV and other networks and serving as an expert commentator on news programs. He tiptoed into reality TV just as it began to take off, working as a “health and human relations expert” for the 2000 U.S. debut of “Big Brother.”

Then, in the middle of the last decade, the metastasizing of gossip sites, tabloid shows, reality TV and celebrity overdoses put addiction, Pinsky’s longtime specialty, at the center of the culture. Alarmed by the tabloids’ portrayal of addiction as yet another indulgence of the rich and famous, he decided to stage a media intervention on this latest misunderstood health crisis. Working with independent producers, he approached VH1 with a proposal for a subversively authentic reality show, in which such common action-inducing tricks as sleep deprivation and free shots of liquor would be unnecessary. Instead, it would follow actual substance-abusing celebrities (as defined by cable) through an actual detox in actual rehab. “It all stemmed from Drew,” says Jeff Olde, VH1’s executive vice president of original programming and production.

Using the decade’s most derided TV genre to combat its most high-profile illness required a mix of showbiz savvy and bona fide credentials few but its host could provide. “Dr. Drew is one of a relatively small number of psychiatric professionals who is both credible and 100 percent TV-friendly,” says Michael Hirschorn, the former head of original programming at VH1 who gave the green light to “Rehab” in 2007 (and for whom I worked at Spin in the late ’90s). “And he was willing to take all of the risks on himself, to say, ‘I’m gonna guarantee that this will be a legitimate and nonexploitative process.’ ”

In 2008, “Celebrity Rehab” made its debut, with a cast of derailed actors, porn stars, pro wrestlers and reality-TV veterans. It was an immediate hit, prompting two more seasons and the spinoffs “Sober House” and “Sex Rehab With Dr. Drew.” The show didn’t shy away from the tropes of train-wreck TV — the sobbing and fighting, the seizures and vomiting — but it still staked a claim to therapeutic value. While Pinsky’s methods were mainstream, his gentle confrontations with addicts in denial often provided the cat-and-mouse tension of a “Law and Order” cross-examination. In an inspired cultural mash-up, “Celebrity Rehab With Dr. Drew” aligned reality TV’s need for conflict and meltdowns with recovery’s need for honesty, humility and group support. And it pre-empted charges of intrusive voyeurism by appropriating the dictum “You’re as sick as your secrets.” With reality gimmicks like emo-rock cues, dramatic cutaways and chronologically remixed story lines, the show created dependable redemption arcs for its characters that helped distract the audience from the fact that the biggest celebrity on “Celebrity Rehab” was Dr. Drew.

Pinsky soon became the national face of addiction medicine, acquiring a mystique distinct from any other celebrity physician’s. To the general public, “he’s sort of the god of 12 Step,” says Duncan Roy, the 49-year-old British writer-director and patient on the new “Sex Rehab With Dr. Drew.” Roy’s wit and maturity made him an unusual patient for a Dr. Drew show, and he would later write an article questioning Pinsky’s expertise with sex addiction. But shortly after “Sex Rehab” was shown, Roy joined Pinsky on a TV news program and found himself humbled by the doctor’s mastery. “Sitting next to him,” Roy says, he saw that “he has an enormous power. I mean, I’m used to being interviewed but — God.”

Capitalizing on what many saw as his genius for explaining America’s psyche to itself, Pinsky began to focus on what he considered a bigger opponent, the disease that lay beneath them all: a toxic new form of narcissism, stoked by the media. In his latest book, “The Mirror Effect: How Celebrity Narcissism Is Seducing America,” he diagnoses today’s obsession with fame as a potential public health issue. The book incorporates a 2006 study conducted by Pinsky and his co-author, S. Mark Young, in which they subjected 200 celebrities to a standard psychological test, the Narcissism Personality Inventory, and found that celebrities were 17 percent more narcissistic than the average person, reality-TV stars being worst of all. Narcissistic celebrities aren’t exactly news, but this newer variety, according to Pinsky, is. It has been bred for years by casting directors screening for what are known as “Cluster B” personalities, those prone to histrionics, aggression, hypersexuality, drug abuse — and auditioning for reality-TV shows. This emerging strain of supernarcissism, Pinsky says, turns especially virulent in the world of social media, where young people, who are chasing an increasingly accessible kind of fame, begin to mirror the increasingly pathological behavior of their idols. According to Pinsky, our fascination with these newer narcissistic role models may seem a mere guilty pleasure, but, he argues, it is a reflection of the deep, primal chord they strike within us, the desire to emulate and then destroy our icons. It’s a kind of envious compulsion that tabloids have fed for decades and that new media now intensify with fast, cheap dopamine-blasting hits at the click of a remote.

This, says Pinsky, is the real sickness, the American addiction. So just as the intrepid epidemiologist flies to ebola-infested Yambuku, Pinsky has come to meet the monster where it lives. At least that’s the pitch. “Sometimes I think the patient I’m treating is the culture,” he told me. But the addiction model of celebrity comes with its own baggage, especially in a patient population prone to the subtle thought distortions of a brain under the influence. If, as Pinsky and Young write in “The Mirror Effect,” “nothing demonstrates a celebrity’s basic drive for attention more powerfully than a willingness to check one’s dignity at the door, week after week, in front of millions of viewers,” such a perspective casts a strange light on a program that gives these same people high doses of their drug of choice, week after week, in front of millions of viewers. Addicts are known for the prodigious logic they supply for patently irrational behavior; if the sickness of the culture is contagious, Pinsky, too, is at risk, and his mode of clinical outreach is potentially exploitation in denial.

On the eighth day of “Celebrity Rehab” treatment, the new cast met with alumni from previous seasons, among them Rodney King, star of what might be coldly described as the most momentous reality-TV clip in history. Seeing King chatting with celebs of utterly featherweight significance prompted me to put a few commonly asked questions to Pinsky. Doesn’t luring cast members with promises of money and exposure cast doubt on their commitment to sobriety? And doesn’t broadcasting amid other hormone-and-booze-soaked reality shows undermine the show’s supposedly dead-serious message? Pinsky had ready replies to both.

“My whole thing is bait and switch,” Pinsky said. “Whatever motivates them to come in, that’s fine. Then we can get them involved with the process.” As for the context in which this proc­ess is made available, this, too, is merely a come-on. “The people that need what we have are watching VH1,” Pinsky said. “Not the people watching educational TV, the NPR crowd. You gotta give ’em what they want so you can give ’em what they need.”

But is Jeff Conaway — the prescription-drug-addicted, alcoholic ex-sitcom-and-sci-fi star who screamed abuse from his wheelchair through much of Season 1 — really what today’s at-risk youth need? Perhaps, Pinsky said, citing the number of patients who arrive at his Las Encinas treatment program and say they came after seeing “Celebrity Rehab.” And, he pointed out, nearly all former cast members credit “Rehab” with helping them. Many physicians who treat addiction salute its efforts, and a large number of recovering addicts praise its portrayal of addiction as a disease.

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None of this counts as statistically significant data, of course. In fact, many take issue with Pinsky’s methods. Jeffrey Foote, a clinical psychologist who specializes in the treatment of substance abuse, points out that “the velvet-glove confrontational stuff Pinsky does is what works for TV, but it’s not what works for patients.” In fact, the Web site for Foote’s Center for Motivation and Change Web site uses a clip from “Celebrity Rehab” to demonstrate poor techniques. “The dramatic confrontations seen on the show are actually more likely to drive less-severe substance abusers, who are by far the majority, away from seeking treatment.” And whether or not the show helps motivate addicted viewers, critics claim that the on-camera treatment of patients is fundamentally compromised. “I think that if you waterboarded [Pinsky], he’d maintain that he’s really helping people,” says Dr. John J. Mariani, director of the Substance Treatment and Research Service at Columbia University. “The problem here is that Dr. Drew benefits from their participation, which must have some powerful effects on his way of relating to them. He also has a vested interest in the outcome of their treatment being interesting to viewers, which is also not in their best interest. Treatment with conflicts of interest isn’t treatment.”

Pinsky admits that using media to treat media addiction can seem fundamentally contradictory — a way of baiting fame addicts with more fame. “That’s the Achilles’ heel of this thing,” he said. “Gratifying an addict’s sense of specialness.” But he stands by his mission. “The problem with my peers is they don’t understand television,” he said. “You have to work within the confines of what executives will allow you to put on TV. Otherwise, we’ve not done anything, we’ve not really struggled to change the culture at all.”

Late one sunny afternoon, Pinsky picked me up in his black Lexus to drive to the “Larry King Live” studios in Hollywood. He had been booked to advance his theories on what led to the hospitalization of the British singing star Susan Boyle, to limn the psychological fissures in the marriage of Jon and Kate and to answer the question: “Reality Television Out of Control?” He wore a navy blazer and silver tie that harmonized spectacularly with his hair.

Right after I climbed in, he showed me a text message he’d just received: “One year clean and sober June 10th. Thank you so much.” “Nikki McKibbin,” he explained. “From Season 2. She was a difficult drug-addict-alcoholic and had never contemplated getting better. This was her only addiction treatment, I think.” A few minutes later his cellphone rang. “Tom Sizemore,” he said, with a glance at caller ID. He spoke for a minute, hung up and chuckled. “O.K., here’s how addicts work,” he said. “That was Seth Binzer,” from the show’s first and second seasons, “calling on Tom Sizemore’s phone to get directions to a therapist’s office. I love addicts.”

Pinsky traces that love to what lay beneath the surface of his otherwise happy childhood in Pasadena. His mother, a retired actress and singer, suffered a near fatal miscarriage and was taken from home in an ambulance when Pinsky was 1. This event, Pinsky writes in his memoir, “Cracked,” triggered a lifelong anxiety he tried to manage with certain compulsions. “I rescue people,” he writes. “I have to make sure no one else gets carted away.”

As we drove, I was struck by Pinsky’s disarming conversation style, which involved frequent nods, appreciative laughs, affect mirroring and gentle knee pats — all of which had me sharing intimate details about my childhood before we reached the Hollywood border. Apparently, this comes with the territory. “We affect each other,” Pinsky said of his relationship with addicts. “You’re telling people, I’m here with you, having your feelings, sharing them, understanding them, appreciating them.” As Pinsky described it, his function is fairly modest, a mere facilitation of basic human contact. “I’m Buberesque in my thinking,” he said. (The philosopher Martin Buber saw the path to divinity through human contact.) “Before there is a self there is an Other,” he said, negotiating a tight turn. “In human development. Period.”

Pinsky, who in addition to his media work maintains a private practice, teaches psychiatry at the Keck School of Medicine at U.S.C. and directs the chemical-dependency services department at Las Encinas, said he lives a quiet life. Long ago, he had what he describes as “very limited” experience with the substances that his patients use. Though he does drink, moderately, his only real vices are compulsive exercise — running daily one month, lifting weights the next — and the workaholism he attributes to the angst stemming from his childhood. His main passions, aside from his work, are his wife, Susan, and their 17-year-old triplets, Douglas, Jordan and Paulina. He doesn’t count fame as even a secondary motivation. “Now I just want to see my kids do well and hang out with them and I want to make a difference,” he said.

While this suburban idyll certainly suits his public image, others insist there is indeed a celebrity Dr. Drew. “He goes to parties, he does the whole kind of L.A. thing,” says Duncan Roy, the British director from “Sex Rehab.” “He doesn’t just go back to his surgery and pore over medical journals. I mean, he’s a celebrity doctor.”

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Pinsky at the center for drug addicts and alcoholics where his program “Celebrity Rehab With Dr. Drew” is taped.Credit
Jeff Minton for The New York Times

Whether this role rewards or induces grandiosity, Pinsky does show certain signs of it. Roy recalls his surprise in an unbroadcast moment from “Sex Rehab” when he complimented Pinsky on some work. “He very quickly said, ‘You shouldn’t treat me as a God,’ ” Roy says, bursting into laughter. “I said, ‘I’m not!’ He immediately went to that place where any kind of compliment confirmed his omnipotence. He’s a good guy, a sweet guy, but he’s a TV guy. In some way, I think he wrote the book on narcissism to understand his own.”

In “The Mirror Effect,” Pinsky admits that he scored a high 16 on the Narcissism Personality Inventory and shares several traits with the “closet narcissist,” who may seem unassuming but manifests narcissistic traits like overattentiveness and exceeding vulnerability. And Pinsky certainly seems self-effacing to those who know him. “For a long time at the radio station, if an assistant came into the booth and asked him to go get coffee, he’d do it,” Adam Carolla says. “Seriously. I had to remind him they’re supposed to do that for him.” He can also be extraordinarily solicitous. If half the people who claim to stay in contact with Pinsky do so, he must be on the phone every minute. The comedian Andy Dick, who arrived on “Sober House” solely to get treatment from Pinsky, has since made him his primary-care physician. “It’s almost like getting on the phone and calling God,” Dick told me. “We’re in contact constantly. A while ago, I was up at 3 a.m., having a panic attack, and I called three people — Drew, my lawyer and someone else. Drew’s the one who called me back and helped me, right then. I hear people say he’s like a media whore or he’s only in it for the attention, but I have to say, he really is just this unbelievably caring guy. He really is. He’s almost too caring.”

Not long ago, on his Twitter page, alongside tweeny text-shorthand interjections like LMAO and IMHO, Pinsky quoted a line from Goethe: “Deeply earnest and thoughtful people stand on shaky footing with the public,” to which he added, “Fascinating and sad but found this to be true.” He posted it during a tumultuous recent period. On Oct. 27, Pinsky’s father died suddenly of a brain bleed. Days later, at his sons’ high-school football game, one of their friends and teammates collapsed on the sidelines. “I ran over there and found him not breathing, eyes open, fixed and disconjugate,” Pinsky said. He resuscitated the boy and kept him alive until the paramedics arrived. “He survived, thank God,” Pinsky told me two weeks later. “And I just heard today he had his first solid meal.” News items hailing the celebrity doctor’s dramatic rescue ran with little comment from Dr. Drew.

Pinsky isn’t always so reticent. In just the past year, he has speculated freely in public (almost all of these statements are available on RadarOnline) about possible signs of mental illness in Joaquin Phoenix’s “Letterman” appearance, diagnosed borderline personality disorder in the Octomom (without ever examining her), warned the president about the risks of disappointing the public, pronounced Michael Jackson’s personal physician negligent, expressed concern about Miley Cyrus’s lack of a normal developmental process during her adolescence and weighed in on Brad Pitt’s marijuana use and Michael Phelps’s bong scandal. His comments about Tom Cruise’s belief in Scientology and Lindsay Lohan’s drug abuse prompted Cruise’s lawyer to compare him to Goebbels and Lohan (to whom “Rehab” producers reportedly offered six figures if she would join their cast) to Tweet: “I thought REAL doctors talked to patients in offices behind closed doors.” It’s a sentiment echoed by some members in Pinsky’s field.

“I don’t mind the criticism, especially from my peers,” Pinsky said. “But really my book is about the emotion envy, and I’m telling you a lot of what you’re talking about is envy. I was never motivated to do these appearances by fame, but to explain the medical facts behind stories so distorted by media ignorance. When a 22-year-old rock star is hospitalized for exhaustion, I’m sorry, somebody needs to go: ‘Um, excuse me, 22-year-olds run around football fields in 120-degree heat, they don’t get exhaustion. It’s something else.’ ”

By being unafraid to call attention to the medical facts and to do so often — on news slots, cable shows, Web sites and radio slots — Pinsky has tapped into a very powerful mode of branding. “He does seem like the designated adult, the voice of reason,” says Anna McCarthy, an associate professor of cinema studies at New York University’s Tisch School of the Arts, who has written about reality TV. “But he relies upon others to emphasize these qualities. Part of his exemplary appearance is a product of context. He needs the crazy people around him in order to appear so sane.”

On my last day in rehab, I sat in the control room amid cables and empty coffee cups, watching simultaneous vignettes unfold on different screens. Just as the doctrine of recovery says that there’s no such thing as a former addict, shows like “Celebrity Rehab” prove there is no such thing as a former celebrity. Whether or not they ever achieve sobriety, the people in that video grid will in some way remain in it forever. Dr. Drew won’t bring them any closer to escape.

On three screens, group therapy was beginning with a new member, Tom Sizemore. Wearing a Lonsdale warm-up jacket, his short hair matted, his eyelids swollen, he rested his head on one fist. He was looking at his ex-girlfriend Heidi Fleiss — whose accusations of harassment and abuse resulted in his conviction on a domestic-violence charge — with an expression that was either fond, bemused or resigned.

On another screen, Pinsky sat in a cornflower blue shirt with a navy-patterned tie, his sleeves rolled up. Earlier he told me that his patients always have a history of trauma. “It’s essential to face this trauma, to feel it, grieve it and let it go, and move on,” he said. After checking in about his mood, Pinsky tried to begin this process with Sizemore. “Tom, do you want to share?”

“My name’s Tom, I’m an addict,” he said.

One of the cast’s sickest addicts and its most accomplished actor, Sizemore was the last to join the show’s cast. In the context of Hollywood, his greatest tragedy wasn’t his ravaged health, his homelessness or his life-threatening addiction, but his fall from an Olympus populated by Pacino, DeNiro, Spielberg and Scorsese to this beige-carpeted, cable-only Hades. He was, in a sense, the show’s quintessential subject and — whether for TV, treatment or some unstable mixture of both — Dr. Drew began leading him to the work of disclosure.

“Do you want to share your life experiences?” Pinsky asked.

“Not today,” Sizemore said.

“May I just say that Tom’s experience, Tom’s childhood experience?” Pinsky told the group. “Common to many experiences here. He actually told a story once that stayed with me.” Pinsky looked at Sizemore with obvious sympathy, then tried to prompt him. “You know?” he said. “About the crib?”

As Pinsky tried to draw him out, Sizemore looked back at Dr. Drew with a soft, tired smile. Finally he said, “Not on TV.”

Chris Norris is a writer based in New York and contributes frequently to New York, GQ and Film Comment.

A version of this article appears in print on January 3, 2010, on Page MM26 of the Sunday Magazine with the headline: Hitting Bottom. Today's Paper|Subscribe